Chapter 6 Textbook Notes

HLTB03 Midterm Notes: Health, Illness, and Health Care in Canada Chapter 6: Transformations in Canadian Nursing and Nurse Education Introduction The first Canadian training school for nursing opened in St. Catharines, Ontario, in 1874. The emergence of the hospital system within the context of burgeoning industrial capitalism set the tone for a nursing force characterized by a unique blend of Christian dedication, Victorian femininity, medical faith, and labour discipline. In this context, nurse training was oriented to produce a cheap, subservient, readily available workforce armed with the basic knowledge of hospital and sanitary procedures. Nursing education is now concentrated in universities and colleges, augmented with symposia on credentialing, specialization, nursing research, and advanced medical technology. Nurses have promoted their occupation, sometimes through militant action, as a profession with distinct skills and privileges based on their claims to a unique body of nursing knowledge. This chapter is concerned with the development of nursing education in Canada. In particular, this chapter emphasizes the ways in which contradictions in the provision and utility of the education of nurses in Canada have Z} ] KZ ]LZZ[}Z]]}L]LZ L]LZoZ ZZK: Nurses and Professionalism Professionalism is the key concept in most recent analyses of nursing. Nurses are regarded as either as constituting a profession, with their traditional low status a relic of the past, as falling short in their drive to professionalism, in which case the reasons for their failure become the focus of analysis. The interrelated factors are commonly cited to highlight this apparent evolutionary progress: the specialization and bureaucratization of health care, increasingly sophisticated medical technology, aLZ2}Z}LZZ[}L professional awareness. New medical knowledge and health care functions have become unequally distributed among participants in the health care system. This has afforded nurses the opportunity to organize and push for increased status and responsibility; they have willingly emulated the medical profession with the assumption that full professionalism is an inevitable income. Education is the vehicle for professional status. More education for more nurses, built around a distinct scientific core of nursing knowledge, would allow nurses simultaneously to adapt to a changing world and to occupy a position of enhanced importance in the division of labour in health care. The second viewpoint paints a less flattering image of nurses. It takes as its starting point the obstacle that nurses face in their quest for status, and concludes that nursing is at best either a semi- or para-profession, most likely doomed to eternal inferiority to the medical profession. Nursing is either virtually ignored or given only passing consideration in much of the literature on the sociology of medicine. We are left with an impression that no matter how strongly nurses struggled in the past to establish their occupational status, they have not worked hard enough. Ironically, this view fits nicely with the first position on LZZ[}ZZ]}Lo]ZK7]]L2]K]o]LZZZZZKL}Zo]lo]Z}}}LZZ[Z ZZ]L Z]]L2 professionalism. Unfortunately, the debate over whether or not nursing is a profession tends to divert attention from questions of greater significance. An alternative explanation of the development of nursing and nurse education focuses on the social relations that give shape to and are influenced by nursing. Nurses are recognized as dependent wage earners who pose problems of cost and control to their employers. Nursing emerges from and acts upon distinct social, structures and practices that are characterized by regular, often contradictory, patterns. Consequently, issues concerning the training and welfare of nurses are viewed as meaningful only when interpreted in the context of wider trends associated with health care organization, policy, and finance. Nurses as Salaried Employees www.notesolution.com